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Zz 2023 Seasonal Maintenance Worker

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1. Personal Information This section is complete This section is incomplete
2. Applicant Statement This section is complete This section is incomplete

Personal Information

Thank you for the interest in employment with the City of Hays, KS. The City of Hays is an Equal Opportunity Employer and we consider applicants for all jobs without regards to race, sex, disability, religion, age, color, national origin, or ancestry, or any other legally protected status.

Please complete the application completely and accurately.
First Name*
Middle Name
Last Name*
Prefered Name (If different than your first name.)
Address*
Apartment Number
City*
State*
Zip*
Phone Number*
Email Address*
Driver's License Number*
Driver's License State*
Is your Driver's License Currently Valid?*
Birthday
***This is used to verify your Driver's License and not seen by the hiring board.
Are you eligible to work in the United States?*
Are you 17 years of age or older?*
Are you related to anyone currently working for the City of Hays?*
If so, who and what is the relationship?*
Position Information
How did you hear about the open position?*
Who did you hear about the position from?*
Explain Other:*
Education/Training
High School
City
State
College
City
State
College
City
State
Highest Education you Completed
Area of Study
Other Education
Other Specialized or Technical Training You Want Us to Know About. (Include Equipment Operations Training.)
Employment History - Start with your most recent job.
Company*
Position*
City*
State*
Phone Number*
State Date*
End Date*
Reason for Leaving/Looking to Leave*
Responsibilities*
Do you have another employment to enter?*
Company*
Position*
City*
State*
Phone Number
Start Date*
End Date*
Reason for Leaving/Looking to Leave*
Responsibilities*
Do you have another employment to enter?*
Company*
Position*
City*
State*
Phone Number
Start Date*
End Date*
Reason for Leaving/Looking to Leave*
Responsibilities*
Do you have another employment to enter?*
Company*
Position*
City*
State*
Phone Number
Start Date*
End Date*
Last Salary*
Reason for Leaving/Looking to Leave*
Responsibilities*
Do you have another employment to enter?*
Company*
Position*
City*
State*
Phone Number
State Date*
End Date*
Reason for Leaving/Looking to Leave*
Responsibilities*
Do you have another employment to enter?*
Company*
Position*
City*
State*
Phone Number
Start Date*
End Date*
Reason for Leaving/Looking to Leave*
Responsibilities*
Do you have another employment to enter?*
Company*
Position*
City*
State*
Start Date*
End Date*
Reason for Leaving/Looking to Leave*
Responsibilities *
Do you have another employment to enter?*
Company*
Position*
City*
State*
Start Date*
End Date*
Reason for Leaving/Looking to Leave*
Responsibilities *
Do you have another employment to enter?*
Company*
Position*
City*
State*
Start Date*
End Date*
Reason for Leaving/Looking to Leave*
Responsibilities *
Do you have another employment to enter?*
Company*
Position*
City*
State*
Start Date*
End Date*
Reason for Leaving/Looking to Leave*
Responsibilities *
Do you have another employment to enter?*
List any additional employment history you may have. Include company, position, dates, and responsibilities.
Continue

Applicant Statement

Applicant Statement
By submitting your application for any position with the City of Hays, you understand and agree to the following statements:
You represent and warrant that the contents of the application are true and correct and that no pertinent information has been omitted.
You authorize investigation of any or all statements on the application including but not limited to: educational background, employment and personal references, reputation, criminal record, motor vehicle department records, employment history, financial and credit history, and military service. You agree to hold harmless any employer, acquaintance, or reference for any information provided to the City of Hays. Falsification, misrepresentation or omission of information could be just cause for dismissal at any time.
You understand that you may be required to take relevant employment testing for the purpose of determining your capability of performing the duties of the position. In the event you need reasonable accommodation for this testing, or for the interview process, if selected, you understand that the City of Hays will make this accommodation. The City of Hays reserves the right to require medical documentation concerning the need for the accommodation.
The City of Hays is committed to a drug-free workplace and requires pre-employment drug screening. If you are selected for employment by the City of Hays, you agree to participate in the appropriate examinations, determined by the position, which may include a pre-employment physical examination, psychological, and physical endurance examinations. These examinations will be paid for entirely by the City of Hays. Costs of transportation and time involved taking the examinations are the responsibility of the applicant.
The City of Hays is committed to a drug-free workplace and requires pre-employment drug screening. If you are selected for employment by the City of Hays, you agree to participate in the appropriate examinations, determined by the position, which may include a pre-employment physical examination, psychological, and physical endurance examinations. These examinations will be paid for entirely by the City of Hays. Costs of transportation and time involved taking the examinations are the responsibility of the applicant.
Applicant Signature*

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Zz 2023 Seasonal Maintenance Worker

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